diazepam,

A charge nurse is planning a staff education session to discuss medications used to treat alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (Select all that apply) 1. Lorazepam 2. Diazepam 3. Disulfiram 4. Naltrexone 5. Acamprosate

1. Lorazepam 2. Diazepam (both benzodiazepines are used during alcohol withdrawal to decrease anxiety and reduce the risk for seizures. )

A family member who takes diazepam (Valium) for anxiety is concerned about the administration of diazepam 10 mg IV to a relative having frequent tonic-clonic seizures that last 10 mins. The nurse provides which of the following explanations? 1) "The drug inhibits the irregular firing across the nerves in the brain." 2) "The drug relaxes peripheral muscles at the spinal level." 3) "The drug reduces the anxiety related to seizure activity." 4) "The drug provides amnesia of the seizure episode."

2) The drug relaxes peripheral muscles at the spinal level. B/c diazepam relaxes smooth muscles at the spinal level as well as in the brain stem at the reticular formation level, it is an effective anticonvulsant to treat status epilepticus. The statement in option 1 is the physiologic process occurring w/ the ingestion of most anticonvulsant drugs, but this is not how diazepam reduces seizure activing. Since the level of consciousness is reduced during seizures, perception of a threate would be imperceptible (option 3). Amnesia is commonly associated w/ seizures w/o the introduction of a drug (option 4)

A patient presents to the emergency department in status epilepticus. Which medication would the nurse anticipate to be ordered first? A) Diazepam (Valium) B) Midazolam (Versed) C) Propofol (Diprivan) D) Phenobarbital

A) Diazepam (Valium)

1. A nurse is completing the admission history for a client who reports drinking one pint of whiskey every week for 8 years. The last drink was 10 hours ago. Which of the following medications should the nurse plan to administer? A. Diazepam (Valium) B. Disulfiram (Antabuse) C. Fluoxetine (Prosac) D. Acetaminophen (Tylenol)

A. Diazepam (Valium) A (Benzodiazepines can be given for withdrawal of alcohol)

The nurse is administering IV diazepam (Valium). When will the nurse expect the onset of the drug to occur? A. Immediately B. Within 5 minutes C. Within 15 minutes D. Within 1 hour

A. Immediately When diazepam is given intravenously, the nurse should expect the onset of the drug to occur immediately.

Shortly after admission to an acute care facility, a male client with a seizure disorder develops status epilepticus. The physician orders diazepam (Valium) 10 mg I.V. stat. How soon can the nurse administer a second dose of diazepam, if needed and prescribed? a. In 30 to 45 seconds b. In 10 to 15 minutes c. In 30 to 45 minutes d. In 1 to 2 hours

b. In 10 to 15 minutes Answer: BWhen used to treat status epilepticus, diazepam may be given every 10 to 15 minutes, as needed, to a maximum dose of 30 mg. The nurse can repeat the regimen in 2 to 4 hours, if necessary, but the total dose shouldn't exceed 100 mg in 24 hours. The nurse must not administer I.V. diazepam faster than 5 mg/minute. Therefore, the dose can't be repeated in 30 to 45 seconds because the first dose wouldn't have been administered completely by that time. Waiting longer than 15 minutes to repeat the dose would increase the client's risk of complications associated with status epilepticus.

2. The nurse is working with a patient admitted with diazepam (valium) overdose. What medication will the nurse anticipate the care provider to order to refer the effect of diazepam? (a)naloxone (narcan) (b)flumazenil (c)acetylcysteine (d)hydrocodone

(b)flumazenil

Which characteristics are shared by diazepam (Valium) and phenobarbital (Luminal)? (Select all that apply.)

- Potential for hangover- Potential for abuse - Use for seizure control

A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which of the following would indicate that the client is experiencing a side effect related to this medication? 1. Headache 2. Drowsiness 3. Urinary retention 4. Increased salivation

2. DrowsinessRationale:Incoordination and drowsiness are common side effects resulting from this medication. Options 1, 3, and 4 are incorrect.

A nurse has administered a dose of diazepam (Valium) to a client. The nurse would take which important action before leaving the client's room? 1. Giving the client a bedpan 2. Drawing the shades or blinds closed 3. Turning down the volume on the television 4. Per agency policy, putting up the side rails on the bed

4. Per agency policy, putting up the side rails on the bedRationale:Diazepam is a sedative-hypnotic with anticonvulsant and skeletal muscle relaxant properties. The nurse should institute safety measures before leaving the client's room to ensure that the client does not injure herself or himself. The most frequent side effects of this medication are dizziness, drowsiness, and lethargy. For this reason, the nurse puts the side rails up on the bed before leaving the room to prevent falls. Options 1, 2, and 3 may be helpful measures that provide a comfortable, restful environment, but option 4 is the one that provides for the client's safety needs.

A patient asks the nurse whether she may take diazepam (Valium) to help her sleep at night. Which information should the nurse include in patient teaching to help prevent adverse effects of diazepam?

Avoid using this drug to induce sleep.

The nurse in the emergency department is caring for a patient with a suspected overdose of diazepam [Valium]. Which agent is most likely to be administered to reverse the effects of diazepam? A. Naloxone [Narcan] B. Flumazenil [Romazicon] C. Acetylcysteine [Mucomyst] D. Vitamin K

B. Flumazenil [Romazicon] Flumazenil [Romazicon], a benzodiazepine receptor antagonist, is the treatment of choice for overdose of the benzodiazepine diazepam [Valium]. Naloxone [Narcan] is used to reverse opioid overdose. Acetylcysteine [Mucomyst] is used to reverse acetaminophen [Tylenol]overdose. Vitamin K is used to reverse warfarin toxicity.

A patient arrives at the emergency room after attempting suicide by taking an entire bottle of diazepam. What antidote will the nurse most likely administer? A) Phenobarbital (Luminal) B) Dexmedetomidine (Precedex) C) Flumazenil (Romazicon) D) Ramelteon (Rozerem)

C ~ Flumazenil is an antidote to benzodiazepine overdose and is administered to reverse the effects of benzodiazepines when used for anesthesia. Phenobarbital, a barbiturate, would further depress the body functions of this patient. Dexmedetomidine is a new hypnotic drug used in the intensive care unit for mechanically ventilated patients. Ramelteon is also new; it is used as a hypnotic. Adverse effects of this drug include depression and suicidal ideation.

A client is ordered to receive diazepam (Valium). The nurse is teaching the client about her medication. Which information would be included in the teaching plan? a. The medication causes high levels of energy and activity. b. The medication is effective in aiding clients with suicidal ideations. c. The medication may be taken concurrently with other benzodiazepines. d. The client may develop tolerance after prolonged use.

D ~ Patients may become tolerant to Valium.

A nurse is caring for a 9-year-old patient and has received an order for diazepam (Valium) 10 mg given orally q.i.d. What is the nurses priority action? A) Perform hand hygiene and prepare the drug. B) Send the order to the hospital pharmacy. C) Determine when to administer the first dose. D) Call the physician and question the order.

D ~ The first action of the nurse would be to call the physician and question the order. The normal oral dosage for a pediatric patient is 1 to 2.5 mg t.i.d. or q.i.d. The ordered dose would be unsafe for this patient. If the dosage was changed and the correct amount administered, the nurse would order the medication from the pharmacy if necessary and determine what time to start the medication. She would then wash her hands in preparation for administering the medication, but not until obtaining an appropriate dosage of medication.

The nurse on a large med-surg unit administered 3 doses of diazepam (Valium) 10 mg IV at 15-min intervals to a client experiencing status epilepticus. After the seizure acitivity ceases, the nurse adds which intervention to the care plan? 1) Perform oropharyngeal suctioning every 2-3 hours 2) Reposition the client every 2-4 hours 3) Teach the family members at the bedside about the side effects of the drug 4) Monitor for drug side effects for the next 4-5 hours.

Teach family members at the bedside about the side effects of the drug. Diazepam is a benzodiazepine and CNS depressant. B/c diazepam has a half-life of 20-50 hrs, a risk of life-threatening side effects such as cardiovascular collapse and laryngospasms exist. Family members at the bedside need to be aware of the signs/symptoms of the side effects (4). A 4-5 hour interval of assessment is insufficient when compared to the half-life of the drug (4). Unless the client demonstrates impaired airway clarance, suction would not be necessary (1). Re-positioning the client is routin nursing care, but not unique to administration of this drug (2)

2. A nurse is admitting a toddler to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? a. Acetylcysteine b. Narcan c. Flumazenil d. Dantrium (Dantrolene Sodium)

a. Acetylcysteine Acetylcysteine is the correct antidote for Acetaminophen overdose. Narcan is for opioid overdose, Flumazenil is for Diazepam overdose and Dantrium is for Malignant Hyperthermia.

The nurse is assessing a newly admitted patient who has a history of seizures. During the assessment, the patient has a generalized seizure that does not stop for several minutes. The nurse expects that which drug will be ordered for this condition? a) valproic acid (Depakote) b) neurontin (Gabapentin) c) carbamazepine (Tegretol) d) diazepam (Valium)

d) diazepam (Valium)

The patient has been started on a treatment regimen that includes imipramine (Tofranil). The patient tells the nurse that he also is being treated with diazepam (Valium) for a separate condition. What is the nurse's highest priority action? a. Notify the pharmacy because the dosage of the imipramine (Tofranil) will need to be increased. b. Notify the health care provider because the patient may experience an anaphylactic reaction. c. Notify the pharmacy because the dosage of the imipramine (Tofranil) will need to be decreased. d. Notify the health care provider because central nervous system (CNS) depression may result.

d. Notify the health care provider because central nervous system (CNS) depression may result.

A male client has a history of painful, continuous muscle spasms. He has taken several skeletal muscle relaxants without experiencing relief. His physician prescribes diazepam (Valium), 2 mg P.O. twice daily. In addition to being used to relieve painful muscle spasms, diazepam also is recommended for: a. Long-term treatment of epilepsy. b. Postoperative pain management of laminectomy clients. c. Postoperative pain management of diskectomy clients d. Treatment of spasticity associated with spinal cord lesions.

d. Treatment of spasticity associated with spinal cord lesions. Answer: DRationale:In addition to relieving painful muscle spasms, diazepam also is recommended for treatment of spasticity associated with spinal cord lesions. Diazepam's use is limited by its central nervous system effects and the tolerance that develops with prolonged use. The parenteral form of diazepam can treat status epilepticus, but the drug's sedating properties make it an unsuitable choice for long-term management of epilepsy. Diazepam isn't an analgesic agent.